This invention relates to apparatus for the introduction of fluids such as air, oxygen, anesthetics and the like into a patient's lungs and more particularly to a tubular body adapted for both endotracheal and esophageal intubation.
It is often necessary or desirable in surgical procedures and the like to control the patient's breathing by intubation of the patient's trachea for the introduction of air, oxygen or anesthetic into the patient's respiratory system. Intubation devices ordinarily include an elongated flexible tubular body and an inflatable cuff is normally provided on a portion of the tube which is inserted in the patient's trachea to provide a seal between the tracheal lining and the walls of the tube. The end of the tube opposite the inserted end is adapted for connection to suitable apparatus for the introduction of air, oxygen, anesthetic or the like. Examples of such devices are disclosed in U.S. Pat. Nos. 3,460,541, Doherty and U.S. Pat. No. 3,599,642, Tindel. Such endotracheal devices, although successful in maintaining an open airway for the patient can be difficult to insert, particularly in case of an emergency, and normally require the services of a highly skilled person for proper insertion of the device without injuring the patient.
A second type of intubation device has been used, particularly in emergency situations where prompt administration of artificial respiration is critical. Such devices are elongated tubular bodies which are designed to be inserted into the patient's esophagus and which are provided with a plurality of openings spaced on the upper portion of the tubular body for fluid communication with the patient's respiratory passage. The use of such a device ordinarily results in the inflation of the patient's stomach which can result in the flow of stomach contents back up through the tube. Such counterflow of stomach contents is both unpleasant to a person administering artificial respiration and is also dangerous to the patient since some of the stomach fluids may enter the respiratory passages and eventually the lungs of the patient. To avoid this, apparatus designed for esophageal intubulation can be sealed at the inner end to prevent inflation of the stomach with air, oxygen or the like and to prevent the counterflow of stomach fluids up through the tube. An example of such a device is disclosed in U.S. Pat. No. 3,683,908 Don Michael, et al.
Generally speaking, and circumstances permitting, endotracheal intubation is preferred over esophageal intubation as being the most efficient method for introduction of fluids into the patient's lungs. However, where time does not permit, or where skilled personnel are not available, esophageal intubation is utilized since it is quicker and easier to insert a tube into the patient's esophagus without risk of serious injury to the patient.
From the above discussion it can be seen that it is necessary for a hospital and/or emergency facilities such as fire departments and the like, to stock both endotracheal and esophageal intubation tubes in order to be prepared for the eventuality that one or the other procedure will be required for the proper treatment of the patient. This unduly multiplies the number and type of intubation devices required to be on hand and adds to the expense of hospital and emergency facility operations. Also, in connection with esophageal intubation, in approximately 20% of esophageal insertions the tube will accidently enter the trachea resulting in a blockage of the patient's airway, if a conventionally sealed tube is being used.